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Kids With Psoriasis More Likely to Be Overweight: Study

MONDAY, Nov. 19 (HealthDay News) -- Children who have the skin
condition psoriasis are about twice as likely to be either
overweight or obese as kids without the skin problem, according to
new research that looked at children from nine countries.

When researchers looked at just obesity, they found those with
the skin condition were four times as likely to be obese, said Dr.
Amy Paller, a professor and chair of dermatology at Northwestern
University Feinberg School of Medicine, who led the study. It is
published online Nov. 19 in the
Archives of Dermatology.

U.S. children with severe psoriasis were seven times as likely
to be obese as children without the skin condition.

"Pediatric psoriasis is a little bit of an orphan," Paller said. "It's very little studied."

She decided to take a closer look, especially because much
research has shown that adults with psoriasis are often overweight.
Experts have found a link, not cause and effect.

Psoriasis is marked by red, often itchy and scaly lesions. They
can be confined to just some areas, such as the scalp and elbows,
or cover much of the body.

The condition can make children self-conscious, affecting their
social life and willingness to exercise, among other things,
according to Paller.

She evaluated 614 children, ages 5 to 17. While 409 had
psoriasis, 205 did not and served as the comparison group.

Of those with psoriasis, about half had mild forms and the other
half severe.

About 30 percent of the children with psoriasis had an immediate
family member with it. Experts know there is a strong genetic
component to the condition.

The findings did not surprise Paller. "We found that, as we
suspected, the body mass index of the overall group of kids with
psoriasis was much higher,'' she said. Body mass index (BMI) is a
measurement of body fat that takes height and weight into
account.

Even the children with mild psoriasis were more likely to be
overweight.

Which condition drives the other? "My speculation is that they
are heavy and that psoriasis is part of the metabolic disease," she
said.

Experts know that an overproduction in the body of substances
called inflammatory cytokines is associated with both obesity and
psoriasis in adults. So inflammation may drive both disorders,
according to Paller.

When obese adults with psoriasis lose a lot of weight, their
psoriasis may go into remission, studies suggest.

The new research findings suggest that dermatologists need to
have a more ''holistic'' approach when treating kids with
psoriasis, Paller said. "You can't just jump in and treat them with
systemic medications or topical," she said. Doctors have to heed
weight issues, she added.

In agreement is Dr. Ana M. Duarte, director of pediatric
dermatology at Miami Children's Hospital. She reviewed the study
findings.

"What I took away from this is, we need to get a handle on obesity in this country," Duarte said.

The research findings seem to reflect what she sees in her
practice. "Thinking back, some of my obese patients have more
severe disease," she said. "The milder are not as obese."

For parents, the best advice is to seek a doctor's care, said
Dr. Lawrence Green, chair of the research committee for the
National Psoriasis Foundation. "Whether your child is overweight,
has psoriasis, or both, please seek help from your doctor (for
weight advice) or your dermatologist for help in treating psoriasis
because both conditions cause chronic inflammation in the body and
this can lead to heart and other metabolic disease in their
future," he said.

Another dermatologist discussed the study's implications.

"This paper highlights the clear association between obesity and psoriasis," said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. While it is unclear which comes first, she said, "I suspect that the obesity leads to an increased risk for the development of psoriasis."

The study was funded by the International Psoriasis Council.
Paller reported unpaid investigator work for some pharmaceutical
companies and honoraria from Abbott, Amgen-Immunex, Johnson &
Johnson, and Leo Pharma. Other study authors report research grants
and consultant work for several pharmaceutical companies.

While the study found an association between child obesity and
overweight and psoriasis, it did not prove a cause-and-effect
relationship.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.